Individual
ALEXIS MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
19853 OUTER DR STE 110, DEARBORN, MI 48124-2044
(313) 406-5056
(248) 712-4381
Mailing address
19853 OUTER DR STE 110, DEARBORN, MI 48124-2044
(313) 406-5056
(248) 712-4381
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
156F00000X
Technician/Technologist
Primary
—
—
Other
Enumeration date
09/02/2021
Last updated
01/03/2022
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